Are the risk ratios for asthma and wheezing higher for children under the age of 10 than they are for the survey population as a whole?

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In Week 4, you will continue to assume the role of the public health informatician and use your pre-intervention asthma surveillance data set from the CDC to calculate risk/odds ratios and prevalence/incidence rates. Review the data set from a population perspective and calculate various population ratios and rates for the asthma data in your Excel spreadsheet. You will then answer the following questions in a short application paper of 3–4-pages, explaining your results. You may refer to the suggested readings for this week.
Ratios and Rate Questions

[Note: School populations: Asthma elementary student count in this study is 800 for this school year. School’s population (A + B + C + D) = 7,200 students for this school year.]
• Does one school have a higher number of students with asthma?
• Which school has the highest number of students with wheezing?
• How many students had both asthma and wheezing?
• If you have asthma, what are the odds that you also have wheezing?
• Is the odds ratio for bronchitis and RAD lower or higher than asthma and wheezing?
• How many children with wheezing were prescribed medication? From those results, what is the risk ratio?
• Is the risk ratio for being prescribed medication for asthma higher or lower than being prescribed medication for wheezing?
• Are the risk ratios for asthma and wheezing higher for children under the age of 10 than they are for the survey population as a whole?
• What is the student asthma prevalence for the school district, i.e., A, B, C, D based on total student population as shown above?
• What is the student asthma incident rate for the school district, i.e., A, B, C, D based on total student population as shown above?

Examine and research 1 chronic disease (e.g., heart disease, stroke, cancer, diabetes, arthritis, obesity) and write a paper that discusses the following:
• A comparison of 2 health care policies that are in place (either at the state or federal level) that address the disease
• The impact the disease has had on the U.S. population and health care system as a whole
• Strategies that are in place to educate and promote prevention of the disease through public health at the federal and state levels
• Any challenges and progress to date that has been made in preventing and reducing health risks associated with the disease
• 2–3 strategies that may increase awareness, education, and prevention of that disease

How can greater emphasis on public safety might reduce the risk for various groups of the population

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Prepare a 15- to 20-slide presentation. Make sure your presentation includes audio and either speaker notes, a video capture of yourself delivering the presentation, or full video (see example listed below). The presentation should be between 8 to 10 minutes long.

This windshield survey is a tool used by public health nurses to obtain basic knowledge about a given community.
This survey can be conducted by traveling by car, walking, or taking public transportation to gather information on the health of a community and the members of that community. When conducting this survey, make sure to include all community participants, schools, police, fire, hospitals, clinics, etc. Also, please make sure to download and share your completed presentation with an identified entity in the surveyed community who might be interested in your findings.
For an example project, watch the Community Assessment Windshield Survey video at this link: https://www.youtube.com/watch?v=TGXMoQjXbUk

Cultural competence is an important aspect of public health as well as the public health response in disasters and emergencies. After completing the *Disaster in Franklin County simulation (see below) and reviewing the Cultural and linguistic competency in disaster preparedness and response fact sheet (background reading), please address the following:
Why is cultural competence important in public health efforts in emergency response? Be sure to cite reliable and scholarly sources (peer-reviewed articles) to support your response.

Deliverable Length: 3 paragraphs
Examples of some of the leading causes of death in the U.S. include cardiovascular disease, cancer, diabetes, HIV/AIDS, and suicide. Individual behavior, in addition to genetic or environmental factors, may increase risk factors for various groups in the population. Select one of these leading causes of death and discuss your thoughts on the following:
1. How greater emphasis on public safety might reduce the risk for various groups of the population,
2. Ideas on how to increase public awareness about ways to help reduce risks, and

3. The role of public health policies in supporting community health.

What laws allow for domestic deployment?

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Facilitating an Integrated Response to Public Health Needs in an Emergency

Case Assignment

The military has been activated on several occasions to assist with the public health response in disaster relief efforts. After reviewing the background readings, answer the following questions.

Who requests the deployment of troops in a domestic disaster? (Hint – this can happen at the state or federal level.)
What laws allow for domestic deployment? Specify who can use these laws to deploy troops.
Who is in command of the military in a domestic emergency (keeping in mind the difference between the National Guard and active duty military)?
What are some challenges that exist for emergency management and public health entities with the deployment of troops for a domestic emergency and what are some solutions to these?

write an essay (suggested length of 3–4 pages) in which you do the following:?
A. Explain the role of the major public health personnel, including the public health nurse, involved in the disaster.

B. Describe the chain of command that was used in the simulation for the community health nurse.

C. Discuss the resources available to the community health nurse to deal with situations outside the nurse’s scope of practice.

D. Describe actions taken by the community health nurse when encountered with possible emergency situations during the door-to-door interviews.

E. Describe actions taken by the community health nurse to help the people who were interviewed cope with the situations after the flooding.
1. Discuss techniques that were used or could have been used to calm the fears of the people interviewed.

F. Discuss how other nursing personnel could be prepared to help in responding to a similar emergency with a much larger affected area (e.g., the effect of Hurricane Katrina).

Using the Web Resources provided this week*, identify a current epidemiological concern either at the local, national, or global level. Address the following questions:

• What is the epidemiological concern?
• What population is it affecting?
• What potential population may be affected if this concern is not addressed?
• What are the risk factors associated with the epidemiological concern?
• What public health recommendation can you make to alleviate your identified epidemiological concern?

What policy advice would you give the Minister about developing a more efficient process for approving the use of cannabis for medicinal purposes?

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This document needs to be presented in the form of a Ministerial briefing note, addressed to the relevant Minister. The briefing should be presented from you in your ‘role’ as an official in the relevant government department, and should include the following:
• Appropriate heading: state you designation in the department; the relevant Minister for whom the note is intended; the subject of the note
• Purpose: succinct statement of the purpose of the briefing note
• Background: brief description of the context and history of the policy topic
• Issues: identify the main issues pertinent to understanding the policy topic. The issues should be analysed from multiple perspectives (e.g. historical, financial, economic, political, social and ethical)
• Options: identify and assess alternative policy options
• Recommendations: based on the above analysis, advise the Minister on the most suitable course of action to be taken.

Topics:
Please select one of the following policy issues / questions to be addressed in the Ministerial briefing note.
1. The Federal Government of Australia last year legalised medicinal cannabis use and states regulate its cultivation, with Victoria having already harvested its first cannabis crop for medicinal use. Doctors who want to prescribe cannabis will need special permission. Currently they are doing it on a patient-by-patient basis. The entire practice involves a long process of approvals. Because of this, some patients need to wait months before they actually receive their treatments. This stringent process is put in place to ensure that this highly addictive crops are not unduly used. What policy advice would you give the Minister about developing a more efficient process for approving the use of cannabis for medicinal purposes?

2. The recently released Closing the Gap annual report on the quality of life of Indigenous Australians revealed improvements in some but not all health indicators. What policy advice would you give the Minister in relation to priorities for action to close the life expectancy gap for Indigenous Australians?

3. Levels of risky alcohol use across Australia have shown little improvement across the past decade with around 1 in 10 Australians putting their long-term health at risk through excessive drinking. There is a causal relationship between the affordability of alcohol and alcohol consumption, including strong correlations between price and overall consumption, heavy or problem drinking and harms to both drinkers and others. It is argued that increasing the price of alcohol reduces the amount of alcohol consumed at a population level over time. There are counter arguments as well. One such argument is that the drinkers will still find a way to consume and this may lead to increased crime or less consumption of other goods (including merit goods perhaps) in order to pay for it. What policy advice would you give the Minister in relation to the use of pricing as an effective mechanism to reduce the level of alcohol consumption?

4. One of the greatest public health challenges confronting Australia and many other industrialised countries is the obesity epidemic. The food people consume is a major factor in obesity. It needs to be easier for people to make healthier choices about what they eat. More than a year ago the federal government introduced the health star rating system after a series of discussion with the major stakeholders. However, this rating system is voluntary for industry to implement. It is argued that as it is voluntary, food manufacturers can decide whether a product will display health stars or not. What policy advice would you give the Minister in relation to a voluntary food rating system?

5. Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants. Exclusive breastfeeding reduces infant mortality due to common childhood illnesses such as diarrhoea and pneumonia, and helps for a quicker recovery during illness. However, the rate of exclusive breastfeeding continues to be sub-optimal in many developing countries. Considering a developing country context advise the Minister for Health of that country as to how exclusive breastfeeding could be increased substantially.

Identify and discuss literature regarding the London cholera outbreak

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Public health officials can play a huge part in disaster planning and emergency preparedness.
Analyze disaster response and emergency preparedness:
Identify nursing roles and responsibilities during each phase of disaster management. Consider:
planning
preparedness
response
recovery
Evaluate your community (Miami-Dade) or state’s (Florida) plan for preparedness and disaster management:
Does it include provisions for each phase of preparedness and disaster planning?
Does it clearly account for community needs?
Does the plan include evidence of thought beyond the written report?
Is there evidence of a record keeping system for resources, treatment, and identification of victims?
Are there redundancies built into the plan should one option fail? Are backup plans in place?
Analyze the plan for addressing mass casualty situations.

Review your studies on John Snow and the London cholera outbreak along with what you have learned about experimental study designs. Develop a study design for each of the following major designs presented utilizing the components and concepts comprising Dr. Snow’s cholera outbreak:
• Cross-sectional.
• Case control.
• Cohort.
• Clinical trial.
For each study design address the following components:
• Historical concepts and practices that provided the foundation for the practice of epidemiology and epidemiological research related sciences.
• Advantages of this design as it relates to this health issue.
• Disadvantages of this design as it relates to this health issue.
• Common statistical measures utilized in this study design.
• Sampling issues with each study design as it relates to this health issue.
• Bias in epidemiological research and understand how it is controlled in research design.
For the second part of the assignment, select a recent (within the past 5 years) or a well-known public health issue and complete the following:
• Provide a one-page summary of the outbreak.
• Identify and discuss literature regarding the outbreak.
• Evaluate the effectiveness of the outbreak resolution based on the strengths and limitations of the study designs utilized in the literature.
• Develop a different study design that best fits the outbreak and justify the selection through a discussion of the study design’s strengths and limitations as it relates to your chosen health issue.
• Identify sampling issues you would expect to encounter in your selected study design.
• Review the Study Design Scoring Guide for information on how this assignment is graded.
• Name potential biases possible in this study design and your selected health issue.
This paper should be approximately 6–8 pages in length.

In November 2016 Michael Gannon, the head of the Australian Medical association claimed that ‘obesity is the biggest public health challenge facing the Australian population.’ Is this claim true at the global level and, if so, what steps can be taken to alleviate it? In your answer also look at how other issues such as poverty and the unequal distribution of resources worldwide have affected the ‘obesity epidemic’.

A leader has the ability to combine commitment for improvement with knowledge regarding how to exercise influence and engage support (Dickson & Tholl, 2014). In the areas of nursing and public health, the focus is on improving health. Porter-O’Grady and Malloch (2015) noted several major tasks of 21st-century healthcare leaders. Applying essentials of leadership, to the task listed below and discuss how you would exercise influence and engage support for each of your selected task.
-Helping others adapt to the demands of a value-driven health system

Describe the short-term and long-term impact on your community if the intervention is successful

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SCENARIO
You are a community public health nurse (C/PHN) working with the vulnerable population you identified in Milestone 2. You will choose a specific community health role that would serve this population. You have analyzed the data collected from your windshield survey and vulnerable population assignments (the first two milestones) and identified one community health problem that a nurse can impact. Now, review the scholarly literature or scholarly websites listed below and identify one specific evidence-based nursing intervention that has the potential to improve the health of this group. Then develop a proposal to implement this intervention and a plan to evaluate the outcomes of this intervention. Create a PowerPoint that you could use to present to an organization in your community to request approval for funding and support for this intervention. (You are not required to implement the intervention or present your PowerPoint, though you may want to consider implementing your project in the future).
DIRECTIONS
Watch the Milestone 3 tutorial by clicking this url: https://www.brainshark.com/devry/Milestone3_2016. This tutorial is also available on Course Project page under Course Home.
A. Introduction: (average of 2-3 slides)
• Describe the identified problem
o Include at least two important findings that demonstrate that this is a problem in your community.
• Describe your specific community health role: Some examples of roles are school nurse, parish nurse, home health nurse, occupational nurse, health department nurse etc.
• Identify the purpose of the presentation which is related to proposing a community health intervention and evaluation plan.
B. Identify an evidence based intervention: (average of 2–3 slides).
• Find an evidence-based nursing intervention from a peer-reviewed journal article OR one of the following databases. These databases evaluate research evidence about community health interventions. Be sure that your intervention is one that is recommended. Cite your source on the slide with the author or organization and year.
o Use at least one of the following to identify an evidence based intervention:
? A peer reviewed journal article demonstrating that your intervention has been successful
? The Community Guide (https://www.thecommunityguide.org/) Choose one of the topics in the topic tab to find interventions.
? The CDC Community Health Improvement Navigator Database of Interventions (https://wwwn.cdc.gov/chidatabase)
? Healthy People 2020 evidence-based interventions. Find a relevant topic area at (https://www.healthypeople.gov/2020/topics-objectives), click on that topic area, and then click on the “Interventions and Resources” tab to see the evidence-based interventions list for that topic area
• Provide a brief overview of your intervention.
• Discuss why this intervention is a good fit for your community (why you expect it to be effective in your community).
C. Intervention Implementation: (average of 3–4 slides).
Describe how you would implement your community health nursing intervention in your community
• Discuss the actions will you take as the community health nurse to accomplish this intervention.
o Relate your actions to the Public Health Intervention Wheel (Nies & McEwen, 2015, p. 14, Figure 1-3)
• Identify your target population.
• Describe how you will reach out to your target population.
o Include strategies to engage your target population.
• Describe where the intervention will take place.
• Identify when your intervention will take place
o Will it take place once or multiple times?
• Identify those in the community that you will collaborate with (e.g., physician’s office, church, local resources, etc.).
• Explain what level(s) of prevention is your intervention addressing (primary, secondary, or tertiary prevention)?
D. Proposed Evaluation Methods: (average of 2–3 slides)
Your presentation must include at least one proposed quantitative or qualitative evaluation method that you would use to determine whether your intervention is effective. Outcome measurement is a crucial piece when implementing interventions.
• Describe the method you would use to evaluate whether your intervention was effective. (There is a helpful tool found in Course Resources to assist you with understanding qualitative and quantitative methods of evaluation).
• Identify the outcomes you would track to show whether your intervention works (eg. BMI would be one outcome you could track for a weight loss intervention).
• When would you measure these outcomes?
• Describe the short-term and long-term impact on your community if the intervention is successful.

Consider effect size and how to determine whether practical or statistical significance exists

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A brief summary of the article you selected. Then briefly explain the interrelationship between the effect size, power, and sample size in the article. Explain whether the effect size was practically significant, statistically significant, or both, and why. Using the article you selected as an example, support the importance of incorporating both practical and statistical significance in study conclusions.

Effect size refers to the strength of a relationship between two variables. It can be expressed through a difference or ratio. Odds ratios, which compare the likelihood of the same event occurring within two separate groups, reflect effect size.
Consider the following two scenarios:
Ten thousand people participated in a survey in which they were asked whether they use a vitamin C supplement and also whether they had experienced cold symptoms the previous winter. The study demonstrated an odds ratio of 1.08 and a p-value of 0.04. Based on this, the researchers recommended the use of vitamin C supplements to avoid experiencing a cold next winter.
Fifty people participated in a survey about stress and a diagnosis of high blood pressure. This study resulted in an odds ratio of 1.6 and a p-value of 0.07. Based on these results, the study was not published and the researchers moved on to other work.
These two hypothetical situations are extremes, but they illustrate the difference between practical and statistical significance. Practical significance is inferred from the size of the effect, while statistical significance is inferred from the precision of the estimate. The effect size reflected in the odds ratio in the first case was 0.08, or an 8% difference in likelihood of a cold based on vitamin C supplementation (small practical difference of 8%, but statistically significant, with a p-value of 0.04). The effect size in the second case was 0.6, or a 60% difference in the likelihood of a diagnosis of high blood pressure based on stress (large practical difference of 60%, but small statistical significance, with a p-value of 0.07).

Consider effect size and how to determine whether practical or statistical significance exists. Select a public health research study from one of the peer-reviewed journal articles listed in the Week 2 Resources. Consider whether effect size is practically or statistically significant in the study.

Evaluate the degree to which the U.S. is prepared for dealing with acts of bio-terror and infectious pandemic outbreaks

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The National Response Framework (NRF) is an integral part of our nation’s emergency preparedness planning system. It is essential for all public health professionals to understand how this structure supports the National Response Plan (NRP).

Use the Argosy University online library resources and the readings for this module to research the NRF Preparedness Cycle.

Write a report covering the following:

• Capacity building
• Planning
• Organizing, training, and equipping
• Exercising
• Evaluating and improving
Give reasons and examples to support your response. Be sure to use at least two scholarly resources other than your textbook.

Write a 3-page paper in Word format.

Assignment Instructions Prepare a 500-750 word essay: After reading ″Bioterror: Anthrax, Influenza, and the Future of Public Health Security″ by R. W. Johnstone (http://psi.praeger.com.ezproxy1.apus.edu/doc.aspx??x＝x&d＝/books/gpg/C9326/C9326-82.xml&original_url＝doc.aspx?x＝x&d＝/books/gpg/C9326/C9326-82.xml&ws＝WS_PSI&as＝doc.aspx&token＝E0A7B49CD2017486E60E14BAB210174B&count＝.!), Prepare a 500 to 750 word written summary regarding the degree to which the U.S. is prepared for dealing with acts of bio-terror and / or infectious pandemic outbreaks. Your summary should clearly indicate both your position as to which potential specific threat is most probable, in terms of our vulnerabilities, as well as your assessment as to the means / methods by which you believe such attacks could be carried out and how they might mitigated in terms of both response and public health consequences.

Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal Note: This is an individual assignment. Applying what you have learned thus far, develop a community teaching proposal designed to address the needs of your community. Select one of the following as the focus for the teaching plan: Primary Prevention/Health Promotion Secondary Prevention/Screenings for a Vulnerable Population Bioterrorism/Disaster Environmental Issues Complete the ″Community Teaching Work Plan Proposal.″ This will help you organize your plan and create an outline for the written assignment. After completing the teaching proposal, review the teaching plan with a community health and public health provider in your local community. Request feedback (strengths and opportunities for improvement) from the provider. Complete the ″Community Teaching Experience″ form

What are the legal issues that might affect clinical decisions?

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Let’s have a debate!!! Is nursing theory important to the nursing profession? If you believe that it is important, explain why it is useful. If you do not believe that it is useful, explain why nursing theory is not necessary to the profession? Be sure to provide an example that demonstrates your opinion and a scholarly reference (not using the required textbook or lesson) which supports your opinion.

The diversity movement suggests that there is strength in our differences and that our differences enhance each other. At the same time, the movement insists that our differences should not have economic, social, or political consequences. We are entitled to the same access to resources and opportunities regardless of our differences. The human suffering from Hurricane Katrina and the images of victims has stimulated the debate about differential access to resources.
Read the report Women in the Wake of the Storm: Examining the Post-Katrina Realities of the Women of New Orleans and the Gulf Coast. On the basis of your reading, create a report, answering the following:
• Discuss the prominent dimensions of diversity revealed as a result of the Hurricane Katrina disaster.
• Discuss factors that specifically influenced women’s vulnerability to Hurricane Katrina. While answering, consider the primary dimensions mentioned in the lectures as well as the secondary dimensions such as parental and marital status, income, educational level, military experience, geographic location, work background, and religious beliefs.
• Describe the implications for healthcare organizations as a result of the disaster.
• Discuss at least of two of the policy implications that are outlined in the report. If you were given the task to add another policy recommendation what would it be and why?

Medical Indications: The Principles of Beneficence and Nonmaleficence
1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?
2. What are the goals of treatment?
3. In what circumstances are medical treatments not indicated?
4. What are the probabilities of success of various treatment options?
5. In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?
Patient Preferences: The Principle of Respect for Autonomy
1. Has the patient been informed of benefits and risks, understood this information, and given consent?
2. Is the patient mentally capable and legally competent, and is there evidence of incapacity?
3. If mentally capable, what preferences about treatment is the patient stating?
4. If incapacitated, has the patient expressed prior preferences?
5. Who is the appropriate surrogate to make decisions for the incapacitated patient?
6. Is the patient unwilling or unable to cooperate with medical treatment? If so, why?
Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy
1. What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?
2. On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?
3. Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?
4. What ethical issues arise concerning improving or enhancing a patient’s quality of life?
5. Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?
6. What are plans and rationale to forgo life-sustaining treatment?
7. What is the legal and ethical status of suicide?
Contextual Features: The Principles of Justice and Fairness
1. Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?
2. Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?
3. What are the limits imposed on patient confidentiality by the legitimate interests of third parties?
4. Are there financial factors that create conflicts of interest in clinical decisions?
5. Are there problems of allocation of scarce health resources that might affect clinical decisions?
6. Are there religious issues that might influence clinical decisions?
7. What are the legal issues that might affect clinical decisions?
8. Are there considerations of clinical research and education that might affect clinical decisions?
9. Are there issues of public health and safety that affect clinical decisions?
10. Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

What is cultural and linguistic competence?

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A leader has the ability to combine commitment for improvement with knowledge regarding how to exercise influence and engage support (Dickson & Tholl, 2014). In the areas of nursing and public health, the focus is on improving health. Porter-O’Grady and Malloch (2015) noted several major tasks of 21st-century healthcare leaders. Applying essentials of leadership select two (2) tasks from the following list of tasks and discuss how you would exercise influence and engage support for each of your selected tasks.

Deconstructing the barriers and structures of the 20th century
Alerting staff about the implications of changing what they do
Establishing safety around taking risks and experimenting
Embracing new technologies as a way of doing work
Reading the signposts along the road to the future
Translating the emerging reality of health reform into language that the staff can use
Demonstrating personal engagement with health reform
Helping others adapt to the demands of a value-driven health system
Creating a safe milieu for the struggles and pain of changing practice and service
Enumerating small successes as a basis for supporting staff

Describe an issue or problem in public health that could be addressed with a policy change, including:

1. Who or what is affected by the current state of affairs and in what way?
2. What needs to be done differently to improve the problem/issue?
3. What type of policy (i.e., city/county/state ordinance, business/organizational policy) would you recommend?

There are several leadership models that can be applied in health care and public health. Of particular interest to GCU is the servant leadership model. What is “servant leadership”? How does it differ from other models of leadership?

What is a community leader? Give some examples of types of community leaders in public health. What are characteristics of effective community leadership?

What is cultural and linguistic competence? How does this competency apply to public health? Why is this important to the practice of public health?

Review and reflect on the “Values and Beliefs Underlying the Code” section of the assigned reading, “Principles of the Ethical Practice of Public Health,” developed by the American Public Health Association. Which of these values and beliefs most resonates with you or is most relevant to your interests in public health? Why?